<%-- 
    Document   : index
    Created on : Jul 1, 2011, 11:16:12 PM
    Author     : shantha
--%>

<%@page contentType="text/html" pageEncoding="UTF-8"%>
<!DOCTYPE HTML PUBLIC "-//W3C//DTD HTML 4.01 Transitional//EN"
   "http://www.w3.org/TR/html4/loose.dtd">

<html>
    <head>
        <meta http-equiv="Content-Type" content="text/html; charset=UTF-8">
        <title>Epidamic Reporter</title>
    </head>
    <body bgcolor="#AAAAAA">
        <h1>Epidamic Reporter</h1>
	Name of patient:&nbsp;&nbsp;<input type="text" name="txtName" value="" /><br/>
	Age of patient:&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;<input type="text" name="txtAge" value="" /><br/>
	Disease:&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;<input type="text" name="txtDisease" value="" /><br/>
	Date started:&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;<input type="text" name="txtDate" value="" /><br/>
	Discription:&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;<input type="text" name="txtDiscription" value="" /><br/>
	<br/>
        &nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;
	<input type="submit" value="Submit" />
	<input type="submit" value="Edit" />
	<input type="submit" value="Clear" />
	<br/>
	<br/>
	<input type="submit" value="View One" /><br/>
	<input type="submit" value="View two" /><br/>
	<input type="submit" value="View three" /><br/>
        <br/><br/><br/><br/>
        
        <form action="login.jsp">
        <input type="submit" value="Back" />
        </form>
</html>
    </body>
